They also found the greater weight loss led to improved control of blood sugar levels.

"Weight loss may be the single most important therapeutic objective" for the 80 percent of diabetics who are overweight or obese, Dr. J. Bruce Redmon and colleagues write in the journal Diabetes Care.

However, standard weight loss programs have not proven very effective. Therefore, the Minneapolis-based team tried a combination of low-calorie diets, energy-controlled meal replacements, and the weight-loss drug sibutramine (Meridia).

Twenty-nine patients with type 2 diabetes were assigned to a control group that was given standard treatment, which included education, counseling and individualized exercise and diet prescriptions. Thirty other patients got the same treatment plus sibutramine daily and meal replacement products for 1 week every 2 months. The Slim Fast Foods Company provided meal replacement products and snack bars.

At 1 year, the combination-treatment group lost significantly more weight (average 7.3 kilograms, about 16 pounds) than the control group (0.8 kg).

Average blood glucose levels also decreased significantly in the combination-treatment group, but stayed the same in the standard group. Moreover, seven combination patients but only one standard patient required less diabetes medication.

Even though the replacement meals and snacks are high in sugar and other carbohydrates, the research team saw no problems with blood sugar levels, Dr. Redmon told Reuters Health.

He was "not sure that people would tolerate it that well" if the frequency of low-calorie diet weeks were to be increased.

"We found we could do this aggressive program for 1 week and then periodically repeat that," he said, adding that overall, the program was safe and easy to implement. His team will continue following the patients for at least another year, with the control group switched to the combination program.

Source: Yahoo News: Reuters Health: Diabetes Care, September 2003.